BACKGROUND:The prevalence of osteoporosis is high in postmenopausal women,but muscle mass,grip strength,and how these factors affect osteoporosis are understudied,and the exact link between them has not been clarified.OBJECTIVE:To investigate the correlation between muscle mass,grip strength,appendicular skeletal muscle index and bone mineral density in postmenopausal women with osteoporosis and to assess the potential values of these indices in predicting and diagnosing postmenopausal osteoporosis.METHODS:Eighty-three postmenopausal women were collected from the outpatient clinic of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2023 to January 2024.General data were collected.Bone mineral density was detected.T-value,muscle mass of each part,grip strength were recorded.The body mass index and appendicular skeletal muscle index were calculated.The patients were categorized into non-osteoporosis group(n=17)and postmenopausal osteoporosis group(n=66)according to T value and fracture history,and were statistically analyzed accordingly.RESULTS AND CONCLUSION:(1)The body mass,body mass index,bone mineral density of the overall lumbar spine,muscle mass and appendicular skeletal muscle index were higher in the non-osteoporosis group than the osteoporosis group(P＜0.05).(2)Muscle mass was positively correlated with bone mineral density of the overall lumbar spine and individual vertebrae(P＜0.05).(3)Multiple stepwise linear regression analysis showed that body mass and grip strength were linearly and positively correlated with muscle mass;body height and muscle mass were linearly and positively correlated with grip strength,and body mass was linearly and negatively correlated with grip strength.Body mass index was linearly and positively correlated with bone mineral density,and age was linearly and negatively correlated with bone mineral density.(4)Analysis by receiver operating characteristic curve showed that:muscle mass(the area under the curve,sensitivity,specificity and critical value of muscle mass were 0.744,76.50％,74.20％and 36.50 kg,respectively,with P=0.002)and appendicular skeletal muscle index(the area under the curve,sensitivity,specificity and critical value of appendicular skeletal muscle index were 0.739,82.40％,62.10％and 5.81 kg/m2,respectively,and P=0.002)had good predictive value for postmenopausal osteoporosis.To conclude,a reduction in muscle mass and appendicular skeletal muscle index can help to predict the risk of postmenopausal osteoporosis,and the possibility of osteoporosis should be taken into account in postmenopausal women when muscle mass is＜36.50 kg or appendicular skeletal muscle index is＜5.81 kg/m2,in order to prevent the occurrence of postmenopausal osteoporosis.

BACKGROUND:The prevalence of osteoporosis is high in postmenopausal women,but muscle mass,grip strength,and how these factors affect osteoporosis are understudied,and the exact link between them has not been clarified.OBJECTIVE:To investigate the correlation between muscle mass,grip strength,appendicular skeletal muscle index and bone mineral density in postmenopausal women with osteoporosis and to assess the potential values of these indices in predicting and diagnosing postmenopausal osteoporosis.METHODS:Eighty-three postmenopausal women were collected from the outpatient clinic of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2023 to January 2024.General data were collected.Bone mineral density was detected.T-value,muscle mass of each part,grip strength were recorded.The body mass index and appendicular skeletal muscle index were calculated.The patients were categorized into non-osteoporosis group(n=17)and postmenopausal osteoporosis group(n=66)according to T value and fracture history,and were statistically analyzed accordingly.RESULTS AND CONCLUSION:(1)The body mass,body mass index,bone mineral density of the overall lumbar spine,muscle mass and appendicular skeletal muscle index were higher in the non-osteoporosis group than the osteoporosis group(P＜0.05).(2)Muscle mass was positively correlated with bone mineral density of the overall lumbar spine and individual vertebrae(P＜0.05).(3)Multiple stepwise linear regression analysis showed that body mass and grip strength were linearly and positively correlated with muscle mass;body height and muscle mass were linearly and positively correlated with grip strength,and body mass was linearly and negatively correlated with grip strength.Body mass index was linearly and positively correlated with bone mineral density,and age was linearly and negatively correlated with bone mineral density.(4)Analysis by receiver operating characteristic curve showed that:muscle mass(the area under the curve,sensitivity,specificity and critical value of muscle mass were 0.744,76.50％,74.20％and 36.50 kg,respectively,with P=0.002)and appendicular skeletal muscle index(the area under the curve,sensitivity,specificity and critical value of appendicular skeletal muscle index were 0.739,82.40％,62.10％and 5.81 kg/m2,respectively,and P=0.002)had good predictive value for postmenopausal osteoporosis.To conclude,a reduction in muscle mass and appendicular skeletal muscle index can help to predict the risk of postmenopausal osteoporosis,and the possibility of osteoporosis should be taken into account in postmenopausal women when muscle mass is＜36.50 kg or appendicular skeletal muscle index is＜5.81 kg/m2,in order to prevent the occurrence of postmenopausal osteoporosis.

Objective To explore the improvement effect of ultrasound microbubble blasting assisted bone marrow mesenchymal stem cells(BMSC)transplantation on diabetic nephropathy(DN)in terms of inflammatory response and renal function via the Toll like receptor 4(TLR-4)/nuclear factor-kappa B(NF-κB)signaling pathway,as well as its specific mechanism.Methods A rat DN model was estab-lished and randomly grouped into the following:Model group,BMSC group,BMSC+microbubble group,and BMSC+microbubble+TLR-4/NF-κB pathway activator lipopolysaccharide(LPS)group,with 12 rats in each group.Additionally,12 rats were selected as the control(CK)group.Biochemical and biuret analysis,HE and Masson staining,ELISA,and Western blotting testing were employed to detect fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),serum creatinine(sCr),blood urea nitrogen(BUN),24-hour urinary total protein(24 h-UTP),pathological changes in renal tissue,fibrosis status,and the expression of interleukin-1 β(IL-1β),tumor necrosis factorα(TNF-α),TLR-4,and NF-κB proteins of rats in each group.Results The renal tissue in the CK group was structurally normal with few collagen fibers.The Model group showed obvious renal tissue lesions and severe collagen fiber deposition;the lesions in the BMSC group and BMSC+microvesicle group were alleviated in turn,while the lesions were aggravated after the addition of LPS compared with the BMSC+microvesicle group.Compared with the CK group,the levels of FBG,TC,TG,sCr,BUN,24 h-UTP,as well as the expression of IL-1β,TNF-α,TLR-4,and NF-κB proteins were increased in the Model group(P＜0.05).Compared with the Model group,the above-men-tioned indices and protein expression were decreased in the BMSC group(P＜0.05).Compared with the BMSC group,the above-men-tioned indices and protein expression were further decreased in the BMSC+microvesicle group(P＜0.05).Compared with the BMSC+mi-crovesicle group,the above-mentioned indices and protein expression were increased in the BMSC+microvesicle+LPS group(P＜0.05).Conclusion The improvement effect of ultrasound microbubble blasting-assisted BMSC transplantation on DN rats may be related to the inhibition of the TLR-4/NF-κB signaling pathway.

Airway management is a critical component of critical patient care.Although traditional methods of airway management are effective to some extent,they still face many challenges,such as difficult airways,delayed endotracheal intubation,endotracheal tube migration,unpredictable airway complications and failure to mechanical ventilation weaning.Artificial intelligence(AI),a technological tool with advanced algorithms,offers important innovations to improve the safety and efficiency of airway management with its multimodal data integration and real-time decision support capabilities.For example,AI can be used in areas such as real-time monitoring of patients′ vital signs,dynamic adjustment of ventilator parameters,monitoring and assessment of airway complications,and assisted robotic tracheal intubation.In addition,AI is able to build predictive models based on big data to help reduce the risk of injury in mechanically ventilated patients and assist clinicians in making timely decisions.This paper reviews the research progress of AI in airway management and discusses issues of privacy and security,ethics,model performance and interpretability that may be faced during the use of AI,and looks forward to a more active role for AI in airway management in future.

Objective:To discern the association between autism-like behaviors and resilience within the ado-lescent demographic.Methods:A total of 7 063 middle school students were selected to assess ASD-like behaviors and resilience in adolescents using the Autism Spectrum Screening Questionnaire(ASSQ)as well as the Resilience Scale for Chinese Adolescent(RSCA).Subgroups bounded by P5 and P95 of the total ASSQ score,a comparative analysis of the resilience scores between these groups was executed.A correlation evaluation and linear regression a-nalysis was carried out between ASSQ and RSCA scores from all participants.Results:The RSCA scores within the high ASSQ scoring group,were inferior to those in the low scoring group.ASSQ scores were negatively correlated with RSCA scores for the full sample(Ps＜0.01);Social interaction scores on the ASSQ were negatively correlated with the five-factor RSCA scores(β=-0.23,-0.27,-0.11,-0.23,-0.37,Ps＜0.05).Conclusion:There was a negative association between autism spectrum disorder-like behaviors and resilience in adolescents,with more severe social interaction symptoms being associated with poorer resilience.

Objective To investigate the prevalence and symptoms of pertussis in patients with cough,and to predict individual risk based on the combination of symptoms.Methods A total of 1 025 patients with cough or contact with pertussis patients were included.Pertussis was confirmed by nasopharyngeal swab PCR.Patients were divided into the juvenile group(278 cases)and the adult group(747 cases)according to age.The duration of cough from onset to study participation,the visual analogue(VAS)score of cough degree and the number of basic symptoms(paroxysmal cough,vomiting after cough,crowing cough,pauses in breathing after cough and fever)were compared between the two groups.The confirmed patients were further grouped by age,and the different symptoms were compared.70%of the sample was used as the training set.Based on the combination of symptoms(paroxysmal cough,post-cough vomiting,chick-crooning cough and pauses in inspirations after coughing),multivariate Logistic regression was used to establish the prediction model and draw the nomogram.30%of the sample was used as the validation set,and the receiver operating characteristic(ROC)curve was drawn.The differentiation of the area under the curve(AUC)evaluation model was calculated.The calibration degree of the model was evaluated by Hosmer-Lemeshow test,and calibration curve was drawn to evaluate the model.Results By PCR,163 cases(15.9%)were confirmed as pertussis.The juvenile group had a longer duration of cough from onset to study participation than the adult group(P＜0.05).The VAS score of cough severity was higher,and the number of basic symptoms of pertussis was more(P＜0.01).In confirmed cases,the proportion of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was higher in the juvenile group than that in the adult group(P＜0.01).In the diagnosed cases,the incidence of paroxysmal cough and post-cough vomiting were higher in the＜1-year-old group compared to the 1-9-year-old group and the≥10-year-old group(P＜0.05).The combination of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was selected by Logistic regression analysis to establish a nomogram model.The AUC of this model in the training set was 0.852,and the Hosmer-Lemeshow test χ2=0.208,P=0.901,and in the verification set,the AUC was 0.899,and the Hosmer-Lemeshow test χ2=4.202,P=0.122.The predicted value in the calibration curve was very close to the theoretical value in the training set and the verification set,and the fitting degree was high.Conclusion The infection rate of pertussis is high in patients with cough.The nomogram model based on combined symptoms has a better prediction effect on pertussis differentiation,which can provide reference for the monitoring of pertussis.

Objective:To discern the association between autism-like behaviors and resilience within the ado-lescent demographic.Methods:A total of 7 063 middle school students were selected to assess ASD-like behaviors and resilience in adolescents using the Autism Spectrum Screening Questionnaire(ASSQ)as well as the Resilience Scale for Chinese Adolescent(RSCA).Subgroups bounded by P5 and P95 of the total ASSQ score,a comparative analysis of the resilience scores between these groups was executed.A correlation evaluation and linear regression a-nalysis was carried out between ASSQ and RSCA scores from all participants.Results:The RSCA scores within the high ASSQ scoring group,were inferior to those in the low scoring group.ASSQ scores were negatively correlated with RSCA scores for the full sample(Ps＜0.01);Social interaction scores on the ASSQ were negatively correlated with the five-factor RSCA scores(β=-0.23,-0.27,-0.11,-0.23,-0.37,Ps＜0.05).Conclusion:There was a negative association between autism spectrum disorder-like behaviors and resilience in adolescents,with more severe social interaction symptoms being associated with poorer resilience.

Objective To investigate the prevalence and symptoms of pertussis in patients with cough,and to predict individual risk based on the combination of symptoms.Methods A total of 1 025 patients with cough or contact with pertussis patients were included.Pertussis was confirmed by nasopharyngeal swab PCR.Patients were divided into the juvenile group(278 cases)and the adult group(747 cases)according to age.The duration of cough from onset to study participation,the visual analogue(VAS)score of cough degree and the number of basic symptoms(paroxysmal cough,vomiting after cough,crowing cough,pauses in breathing after cough and fever)were compared between the two groups.The confirmed patients were further grouped by age,and the different symptoms were compared.70%of the sample was used as the training set.Based on the combination of symptoms(paroxysmal cough,post-cough vomiting,chick-crooning cough and pauses in inspirations after coughing),multivariate Logistic regression was used to establish the prediction model and draw the nomogram.30%of the sample was used as the validation set,and the receiver operating characteristic(ROC)curve was drawn.The differentiation of the area under the curve(AUC)evaluation model was calculated.The calibration degree of the model was evaluated by Hosmer-Lemeshow test,and calibration curve was drawn to evaluate the model.Results By PCR,163 cases(15.9%)were confirmed as pertussis.The juvenile group had a longer duration of cough from onset to study participation than the adult group(P＜0.05).The VAS score of cough severity was higher,and the number of basic symptoms of pertussis was more(P＜0.01).In confirmed cases,the proportion of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was higher in the juvenile group than that in the adult group(P＜0.01).In the diagnosed cases,the incidence of paroxysmal cough and post-cough vomiting were higher in the＜1-year-old group compared to the 1-9-year-old group and the≥10-year-old group(P＜0.05).The combination of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was selected by Logistic regression analysis to establish a nomogram model.The AUC of this model in the training set was 0.852,and the Hosmer-Lemeshow test χ2=0.208,P=0.901,and in the verification set,the AUC was 0.899,and the Hosmer-Lemeshow test χ2=4.202,P=0.122.The predicted value in the calibration curve was very close to the theoretical value in the training set and the verification set,and the fitting degree was high.Conclusion The infection rate of pertussis is high in patients with cough.The nomogram model based on combined symptoms has a better prediction effect on pertussis differentiation,which can provide reference for the monitoring of pertussis.

Objective To analyse the causal relationship between obstructive sleep apnea(OSA)and atrial fibrillation(AF)by Mendelian randomization(MR)method,and to explore the role of inflammatory factors,immune cells,blood metabolites and circulating proteins in it.Methods In this study,MR analysis was used to investigate the causal link between OSA and AF.Inverse variance weighting(IVW),MR-Egger and other methods were used for sensitivity analysis.Additionally,the study also explored the effects of 91 inflammatory factors,731 immune cells,1 400 blood metabolites and 4 907 circulating proteins on AF.Results MR analysis revealed a significant causal relationship between OSA and AF(OR=1.078,P＜0.05).Conversely,reverse MR analysis did not find causal relationship between AF and OSA(P＞0.05).Further analysis revealed that 5 inflammatory factors,19 immune cells,15 blood metabolites and 67 circulating proteins were risk factors for AF.Among them,OSA was the risk factor for one inflammatory factor,one blood metabolite and 12 circulating proteins.There was no significant causal association between OSA and 19 immune cells.Conclusion This study demonstrates that OSA increases the risk of AF.Meanwhile,it is found that inflammatory factors,immune cells,blood metabolites and circulating proteins have potential impacts on the pathogenesis of AF.

Objective To explore the improvement effect of ultrasound microbubble blasting assisted bone marrow mesenchymal stem cells(BMSC)transplantation on diabetic nephropathy(DN)in terms of inflammatory response and renal function via the Toll like receptor 4(TLR-4)/nuclear factor-kappa B(NF-κB)signaling pathway,as well as its specific mechanism.Methods A rat DN model was estab-lished and randomly grouped into the following:Model group,BMSC group,BMSC+microbubble group,and BMSC+microbubble+TLR-4/NF-κB pathway activator lipopolysaccharide(LPS)group,with 12 rats in each group.Additionally,12 rats were selected as the control(CK)group.Biochemical and biuret analysis,HE and Masson staining,ELISA,and Western blotting testing were employed to detect fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),serum creatinine(sCr),blood urea nitrogen(BUN),24-hour urinary total protein(24 h-UTP),pathological changes in renal tissue,fibrosis status,and the expression of interleukin-1 β(IL-1β),tumor necrosis factorα(TNF-α),TLR-4,and NF-κB proteins of rats in each group.Results The renal tissue in the CK group was structurally normal with few collagen fibers.The Model group showed obvious renal tissue lesions and severe collagen fiber deposition;the lesions in the BMSC group and BMSC+microvesicle group were alleviated in turn,while the lesions were aggravated after the addition of LPS compared with the BMSC+microvesicle group.Compared with the CK group,the levels of FBG,TC,TG,sCr,BUN,24 h-UTP,as well as the expression of IL-1β,TNF-α,TLR-4,and NF-κB proteins were increased in the Model group(P＜0.05).Compared with the Model group,the above-men-tioned indices and protein expression were decreased in the BMSC group(P＜0.05).Compared with the BMSC group,the above-men-tioned indices and protein expression were further decreased in the BMSC+microvesicle group(P＜0.05).Compared with the BMSC+mi-crovesicle group,the above-mentioned indices and protein expression were increased in the BMSC+microvesicle+LPS group(P＜0.05).Conclusion The improvement effect of ultrasound microbubble blasting-assisted BMSC transplantation on DN rats may be related to the inhibition of the TLR-4/NF-κB signaling pathway.